Morning journal and courier. [volume] (New Haven [Conn.]) 1848-1894, 1887-02-03
TAKING oUT THE SPLEEN.
The Third Case on Record-The p
tient VIII Recover.

The Third Case on Record-The Pa
tient will Recover.
From the New York Tribune.l
Several weeks ago middle-aged woman
was admitted to the hospital at the Post
Graduate Medical school in West Twentieth
street. Her face was pinched and pale and
showed the traces of long suffering. She
had been sick for years and had been treated
by number of physicians for different
maladies, but despite all that was done for
her she steadily failed. There was some
thing of hidden nature that was slowly un-
dermining her constitution, and for long
time it could not be definitely determined.
There was such constitutional disturbance
that every organ in the body seemed dis
posed [ o shirk its duty, and as the woman
got no relief there was a frequent change OF
physicians and medicines 1t discov-
cred before she was taken to the hospital
that there was displacement of some alb
dominal organ, and that it was roaming
around in a decidedly annoying manner.
The erratic movement of the organ was ac
complished with intense pain, and at times
would induce delirium.
At the hospital careful examination was
made by DR.. J. R. Nilsen, of the house staff,
who came to the conclusion that the itine-
rant vessel was the spleen. A consultation
was held and a majority of the physicians
were opposed to Iesortlng to an operation.
1t was deemed best to leave the spleen alone
upon the supposition that nature would take
care of it in time. But her condition be
came SO much worse and the pain was so vi
olent that the patient lost her courage and
threatened to end her misery in her own
way, and it was decided under the circum
stances the only way that the woman could
be relieved was to extirpate the spleen. This
is exceedingly dangerous operation, and
, tbare nDlv two SI1eoassfu1 rapnr0n n6
in the books, one being reported by DR..
Zaccarelli in 1914, and the other by DR.. Pean
in 1867 Cases in which the operation
suited in death are numerous both in this
country and Europe. The patient was in
formed of the seriousness of her condition
and the regularity with which death had fol
lowed the surgeons knife, but she readily
consented to take the slight chance of living
rather than suffer longer.
The patient was taken to the operating
room. the ether cone was Placed over he1
face and in few moments she was uncon-
scious. After all the preliminary arrange
ments had been made, carefully watched by
Dr. Nilsen, An incision was made in the
linea alba median line, just below the
umbilicus, several inches in length. The
knife was carefully forced through the fai
and tissue until the peritoneum was reached
and then AS precautionary measure its
| course was restricted by a director. The
| was opened wide. The intestines appeared
| and as far as was necessary were taken out
| of the body and wrapped in warm cloths
| The surgeon introduced his hand into the
| cavity and determined the location of the
| liver, kidneys and stomach, but as had beer
| surmised the spleen was not in place. L
| had dropped several inches and was found
| in the pelvic region. 1t hung by the blood
vessels and nerves and was more than three
| times the natural size. There were many
| adhesions to the surrounding mem brane. and
| it required the most delicate manipulation tc
| free the spleen from its artificial attach
| ments without njuring the sensitive tissues.
| The spleen was drawn carefully upward ano
through the abdominal incision, SO that only
| the long pedicle remained inside. A stout
| silk thread was wound tightly around the
! pedicIe in the body as far as could be con
| veniently reached. This was to prevent
| hemorrhage. The pedicle was then severed
and the spleen removed. The splenic branch
of the coelic axis artery was much enlarged
but the ligature prevented any flow of blood.
All the fluids which had been discharged in
the abdomen having been removed and the
exposed organs having been washed with
mercury solution, the wound in the abdomi-
nal wall was closed with silver and catgut
sutures.
The patient bore the shock remarkably
well. The effect of the ether passed away
quickly and careful watch was kept upon
the patient. The dreaded peritonitis did not
appear and she appeared to gain strength
from the moment she was put in her cot.
Several days passed without dangerous
symptom and she was pronounced out of
danger and will recover. The use of the
spleen is not known, but the patient gets
along better without than with it and never
felt so well in her life, the only alarming
feature being her enormous appetite.